Individual
MRS. KATHLEEN NANETTE INMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDA, RDH, BS
Contact information
Practice address
245 S RIDGE ST, PORT SANILAC, MI 48469-9704
(810) 622-8230
Mailing address
248 GEORGE V AVE, CROSWELL, MI 48422-1005
(810) 679-3465
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902003818
MI
126800000X
Dental Assistant
2903000741
MI
Other
Enumeration date
12/08/2010
Last updated
12/08/2010
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